Hemodynamic and neural responses to renal denervation of the nerve to the clipped kidney by cryoablation in two-kidney, one-clip hypertensive rats.
Hemodynamic and neural responses to renal denervation of the nerve to the clipped kidney by cryoablation in two-kidney, one-clip hypertensive rats.
复制标题
在两肾、一夹高血压大鼠中冷冻消融对剪断肾神经去神经的血流动力学和神经反应。
DOI：
10.1152/ajpregu.00331.2015
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Maliszewska-Scislo,Maria
中科院分区：
文献类型：
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作者：
Rossi,NoreenF;Pajewski,Russell;Chen,Haiping;Littrup,PeterJ;Maliszewska-Scislo,Maria
肾动脉狭窄的发病率正在上升。血管成形术加支架植入并没有被证明比药物治疗更好。在这种情况下，不愿意使用现有的去神经支配方法。我们研究了有意识的、长期固定的、双肾单夹（2K-1C）肾血管性高血压模型Goldblatt大鼠，以验证通过肾神经冷冻消融（cro - dnx）到被夹肾的肾去神经控制可以降低平均动脉压（MAP）、血浆和组织ANG II以及对侧肾交感神经活动（RSNA）的假设。5周龄雄性spraguedawley大鼠进行假手术（ShC）或右肾动脉夹闭（2K-1C），放置遥测发射机，并以0.4% NaCl配对喂养。6周后，大鼠被随机分配到冷冻DNX或假冷冻（假DNX）肾神经到夹断的肾脏。MAP在2K-1C组升高，在ShC组和2K-1C组均显著降低。在低温dnx肾脏中，组织去甲肾上腺素降低约85%。血浆ANG II在2K-1C假DNX组较高，而在2K-1C冷冻DNX组与ShC组无明显差异。冷冻dnx后，断肾组织中ANGⅱ降低。与ShC相比，未切除肾的基线综合RSNA在2K-1C中高出三倍，在2K-1C冷冻dnx中下降到与ShC相似的值。低温dnx后，2K-1C期RSNA对压力感受器卸荷的最大反射反应降低。因此，在有意识、自由活动的2K-1C大鼠中，通过冷冻消融肾神经到被夹断的肾脏的去神经支配不仅降低MAP，还降低血浆和肾组织中ANG II的水平以及对侧肾脏的RSNA。
Renal artery stenosis is increasing in prevalence. Angioplasty plus stenting has not proven to be better than medical management. There has been a reluctance to use available denervation methodologies in this condition. We studied conscious, chronically instrumented, two-kidney, one-clip (2K-1C) Goldblatt rats, a model of renovascular hypertension, to test the hypothesis that renal denervation by cryoablation (cryo-DNX) of the renal nerve to the clipped kidney decreases mean arterial pressure (MAP), plasma and tissue ANG II, and contralateral renal sympathetic nerve activity (RSNA). Five-week-old male Sprague-Dawley rats underwent sham (ShC) or right renal artery clipping (2K-1C), placement of telemetry transmitters, and pair-feeding with a 0.4% NaCl diet. After 6 wk, rats were randomly assigned to cryo-DNX or sham cryotreatment (sham DNX) of the renal nerve to the clipped kidney. MAP was elevated in 2K-1C and decreased significantly in both ShC cryo-DNX and 2K-1C cryo-DNX. Tissue norepinephrine was ∼85% lower in cryo-DNX kidneys. Plasma ANG II was higher in 2K-1C sham DNX but not in 2K-1C cryo-DNX vs ShC. Renal tissue ANG II in the clipped kidney decreased after cryo-DNX. Baseline integrated RSNA of the unclipped kidney was threefold higher in 2K-1C versus ShC and decreased in 2K-1C cryo-DNX to values similar to ShC. Maximum reflex response of RSNA to baroreceptor unloading in 2K-1C was lower after cryo-DNX. Thus, denervation by cryoablation of the renal nerve to the clipped kidney decreases not only MAP but also plasma and renal tissue ANG II levels and RSNA to the contralateral kidney in conscious, freely moving 2K-1C rats.